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    <recommendedItem id="20100101_19_307"
                     title="Good Results in Poor-Risk Rectal Cancer (CME/CE)"
                     score="0.002"
                     href="http://www.medpagetoday.com/HematologyOncology/ColonCancer/tb/18169?impressionId=1265799601735"
                     
      &lt;p&gt;Patients with high-risk rectal cancer had high response and three-year survival rates on a regimen of preoperative chemotherapy, followed by standard chemoradiation and then surgical resection, according to results of a multicenter study.&lt;/p&gt;
&lt;p&gt;Three-fourths of patients had objective responses to neoadjuvant chemotherapy, increasing to 89% after chemoradiation, researchers reported online in &lt;em&gt;The Lancet Oncology&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;Additionally, 97% of patients who underwent surgery had microscopically clear surgical margins. At three years, 83% of patients remained alive, including almost 70% who were progression free.&lt;/p&gt;
&lt;p&gt;&quot;Intensification of systemic therapy with neoadjuvant combination chemotherapy before standard treatment is feasible in poor-risk, potentially operable rectal cancer, with acceptable safety and promising long-term outcomes,&quot; David Cunningham, MD, of the Royal Marsden Hospital in Sutton, England, and co-authors concluded.&lt;/p&gt;
&lt;p&gt;&quot;Future development of this multidisciplinary treatment strategy in randomized trials is warranted.&quot;&lt;/p&gt;
&lt;p&gt;Although surgery remains the primary and potentially curative therapy for localized rectal cancer, local recurrence rates as high as 40% have been reported with conventional resection.&lt;/p&gt;
&lt;p&gt;The introduction of standardized surgery and total mesorectal excision reduced local recurrence rates to less than 10%, which has been associated with improved survival, the authors noted.&lt;/p&gt;
&lt;p&gt;Preoperative radiotherapy and then chemoradiation further reduced the risk of local recurrence, but did not improve overall survival compared with surgery alone.&lt;/p&gt;
&lt;p&gt;Combination chemotherapy has led to higher response rates and progression-free survival compared with monotherapy for patients with advanced rectal cancer, the authors continued. Adjuvant chemotherapy containing oxaliplatin (Eloxatin) also has improved outcomes in resected colon cancer.&lt;/p&gt;
&lt;p&gt;Given that oxaliplatin-fluoropyrimidine combinations have become a preferred standard, investigators designed a clinical trial of high-risk rectal cancer to investigate preoperative treatment with oxaliplatin and capecitabine (Xeloda).&lt;/p&gt;
&lt;p&gt;A previous report involving the first 77 patients enrolled in the trial showed substantial tumor regression, rapid improvement in symptoms, and a high rate of clear surgical margins (&lt;em&gt;J Clin Oncol&lt;/em&gt; 2006; 24: 668-74).&lt;/p&gt;
&lt;p&gt;Nine treatment-related cardiac events occurred in eight of the 77 patients, prompting a protocol amendment to exclude patients with a recent history of clinically significant cardiac problems.&lt;/p&gt;
&lt;p&gt;The updated results comprised 105 patients, and only one cardiac event occurred after the change in eligibility criteria, the authors wrote.&lt;/p&gt;
&lt;p&gt;All of the patients had MRI-defined, poor-risk but nonmetastatic rectal cancer. Patients received four cycles of neoadjuvant chemotherapy over 12 weeks, followed by chemoradiotherapy consisting of a total radiation dose of 54 Gy administered over six weeks, plus daily capecitabine.&lt;/p&gt;
&lt;p&gt;After total mesorectal excision, patients received 12 weeks of adjuvant capecitabine.&lt;/p&gt;
&lt;p&gt;The primary endpoint was pathologic complete response, and median follow-up was 55 months.&lt;/p&gt;
&lt;p&gt;Radiologically confirmed response rates were 74% after neoadjuvant chemotherapy and 89% after chemoradiation. Of 97 patients who had surgery, 93 had microscopically clear margins, and 21 of 105 patients had pathologic complete responses.&lt;/p&gt;
&lt;p&gt;Three-year progression-free and overall survival were 68% and 83%, respectively. Among patients who had surgery, three-year, relapse-free survival was 74%.&lt;/p&gt;
&lt;p&gt;&quot;Our findings show the feasibility of neoadjuvant chemotherapy with capecitabine and oxaliplatin before chemoradiotherapy and total mesorectal excision, which accord with the initial results of this study,&quot; the authors declared.&lt;/p&gt;
&lt;p&gt;&quot;High radiological response rates to preoperative treatment were recorded, and the number of pathological complete responses surpassed the prespecified number needed to meet the primary objective of this trial.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was supported by England&apos;s National Health Service and sanofi-aventis.&lt;/p&gt;&lt;p&gt;Cunningham and co-author Niall Tebbutt disclosed relationships with Roche and sanofi-aventis.&lt;/p&gt;&lt;p&gt;Co-author Ian Chau disclosed relationships with Roche and sanofi-aventis.&lt;/p&gt;&lt;p&gt;Co-author Yu Jo Chua disclosed relationships with Roche and sanofi-aventis.&lt;/p&gt;&lt;p&gt;Co-author Gina Brown disclosed a relationship with sanofi-aventis.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_3986"
                     title="Cancer Report Card Reveals Decline in Disease and Death"
                     score="-0.005"
                     href="http://www.medpagetoday.com/HematologyOncology/Hematology/tb/17385?impressionId=1265799601735"
                     
      &lt;p&gt;Cancer incidence and mortality continue to decline, with the most dramatic decreases in lung, prostate, and colorectal cancers among men, and breast and colorectal cancers in women, according to the latest national report card.&lt;/p&gt;
&lt;p&gt;&quot;Overall cancer incidence rates for all racial/ethnic groups combined decreased by 0.7% per year during 1999-2006 for both sexes combined, by 1.3% per year during 2000-2006 for men, and by 0.5% per year during 1998-2006 for women,&quot; authors from the American Cancer Society, the CDC, the National Cancer Institute, and the North American Association of Central Cancer Registries concluded.&lt;/p&gt;
&lt;p&gt;The report, which has become an annual ritual, was published online in the ACS journal, &lt;em&gt;Cancer.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;There has been a decline in cancer death rates since the early 1990s and that trend appears to be durable.&lt;/p&gt;
&lt;p&gt;&quot;The decreases were slightly larger for men, who had declines of 1.5% per year during 1993-2001 and 2.0% per year during 2001-2006 compared with women, whose cancer death rates declined 0.8% per year during 1994-2002 and 1.5% per year during 2002-2006,&quot; the authors wrote.&lt;/p&gt;
&lt;p&gt;But the news was not all good. As men saw decreased rates of prostate, lung, oral, stomach, brain, and colorectal cancers, there was a concurrent increase in the cancers of the kidney, renal, liver, and esophagus  --  as well as increases in leukemia, myeloma, and melanoma of the skin.&lt;/p&gt;
&lt;p&gt;For women the story was similar -- decreased rates of breast, colorectal, ovarian, cervical, uterine corpus, and oral cancers, but an uptick in lung, thyroid, pancreas, bladder, and kidney cancers, as well as increases in non-Hodgkin lymphoma, melanoma, and leukemia.&lt;/p&gt;
&lt;p&gt;Colorectal cancer is a focus of this year&apos;s report, not a surprising choice because the news here is good: &quot;CRC death rates have declined since 1984 in both men and women, with an accelerated rate of decline since 2002 (for men) and 2001 (for women).&quot;&lt;/p&gt;
&lt;p&gt;And a &quot;microsimulation model&quot; suggests that death rates from colorectal cancer could be reduced by 36% over the next decade if &quot;1995-2000 trends for risk factor prevalence, screening, and treatment continue.&quot;&lt;/p&gt;
&lt;p&gt;But the authors point out that increased obesity among younger Americans could derail this trend.&lt;/p&gt;
&lt;p&gt;The annual report often paints a rosy picture based on a patchwork of data collected from a number of sources and analyzed using a complex array of statistical methods.&lt;/p&gt;
&lt;p&gt;The report&apos;s lead author, Brenda K. Edwards, PhD, of the National Cancer Institute, and her colleagues, provide detailed descriptions of potential problems  --  so much so that the report includes two pages of possible limitations.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_223"
                     title="ASCO GI: Regimen Benefits Colon Cancer Patients of All Ages"
                     score="-0.005"
                     href="http://www.medpagetoday.com/MeetingCoverage/ASCOGI/tb/18076?impressionId=1265799601735"
                     
      ORLANDO -- Patients with early-stage colorectal cancer benefit from adjuvant chemotherapy with capecitabine (Xeloda) and oxaliplatin (Eloxatin) regardless of age, according to a new analysis of data from a large multicenter clinical trial.&lt;br&gt;
&lt;br&gt;Disease-free survival (DFS) at three years increased from 60% with a control regimen to 66% with the capecitabine/oxaliplatin (XELOX) regimen among patients 70 or older.&lt;br&gt;
&lt;br&gt;Younger patients had a 3% absolute improvement in three-year DFS when treated with the regimen (72% versus 69% for the control group).&lt;br&gt;
&lt;br&gt;Similar results emerged from an analysis that used 65 as the age cutpoint, according to a presentation at a press briefing prior to the 2010 Gastrointestinal Cancers Symposium.&lt;p&gt;&lt;/p&gt;
&lt;p&gt;&quot;XELOX is a new standard of care for patients with early colon cancer, regardless of age,&quot; said Daniel G. Haller, MD, of the University of Pennsylvania. &quot;Patients receiving XELOX immediately after surgery live disease-free for longer, and there is a trend towards superior overall survival with XELOX.&quot;&lt;/p&gt;
&lt;p&gt;The results contradict those of other recent studies that showed no survival benefit with the XELOX regimen in older patients. The reasons for the contradictory findings have yet to be determined, said Haller.&lt;/p&gt;
&lt;p&gt;The findings came from a subgroup analysis of the NO16968 trial. It compared XELOX with bolus intravenous 5-FU/leucovorin, which was the standard of care for stage III colon cancer when the trial began.&lt;/p&gt;
&lt;p&gt;The analysis was performed after two studies reported last year showed that the survival benefit of the regimen was limited to younger patients (&lt;em&gt;ASCO&lt;/em&gt; 2009. Abstract 4010, &lt;em&gt;J Clin Oncol&lt;/em&gt; 2009; 27: 3109-116).&lt;/p&gt;
&lt;p&gt;NO16968 involved a total 1,886 patients, including 409 patients who were ages 70 or older. Study participants were randomized to XELOX or the control regimen, and the primary endpoint was DFS.&lt;/p&gt;
&lt;p&gt;After a median follow-up of 57 months, the three-year DFS in patients younger than 70 was 72% with XELOX and 69% with the control regimen, representing a 21% reduction in the hazard ratio (95% CI 0.66 to 0.94).&lt;/p&gt;
&lt;p&gt;Among older patients, the 6% absolute difference in DFS favoring XELOX constituted a 13% reduction in the hazard ratio (95% CI 0.63 to 1.18).&lt;/p&gt;
&lt;p&gt;When the definition of &quot;older&quot; patients was 65 and older, XELOX still resulted in a 6% absolute difference in DFS compared with the control regimen (68% versus 62%, HR 0.81, 95% CI 0.64 to 1.03). Among patients younger than 65, XELOX led to a three-year DFS of 72% versus 69% with 5FU and leucovorin (HR 0.80, 95% CI 0.65 to 0.98).&lt;/p&gt;
&lt;p&gt;In response to a question, Haller acknowledged that the DFS difference in older patients did not achieve statistical significance, but he said the principal objective of the study was to examine the data for evidence of trends.&lt;/p&gt;
&lt;p&gt;Overall survival data were not sufficiently mature to perform definitive analyses. However, Haller said the data demonstrated trends in favor of XELOX for all age groups evaluated.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;Haller disclosed relationships with sanofi-aventis and Hoffmann-La Roche.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_3611"
                     title="Report Highlights Cancer Advances"
                     score="-0.005"
                     href="http://www.medpagetoday.com/HematologyOncology/OtherCancers/tb/16892?impressionId=1265799601735"
                     
      &lt;p&gt;As the war on cancer enters its fifth decade, 51 studies stood out as examples of progress that occurred in the past year, as determined by the American Society of Clinical Oncology (ASCO) and reported in &quot;Clinical Cancer Advances 2009.&quot;&lt;/p&gt;
&lt;p&gt;Reflecting input from specialists throughout the field, the ASCO annual report highlights research developments for nine types of cancer, as well as cancer disparities, quality of life and quality of care, and cancer prevention and screening.&lt;/p&gt;
&lt;p&gt;&quot;As this report demonstrates  --  and as history shows  --  investment in clinical cancer research pays off,&quot; ASCO president Douglas Blayney, MD, of the University of Michigan in Ann Arbor, said in a statement included in the report.&lt;/p&gt;
&lt;p&gt;&quot;Since 1990, cancer mortality rates have declined by 15%. Today, two-thirds of patients survive at least five years after diagnosis, compared to just half of patients 40 years ago.&quot;&lt;/p&gt;
&lt;p&gt;&quot;Thanks to basic research advances, we are entering an era of personalized cancer medicine, in which treatment is tailored to the unique genetics of the individual,&quot; Blayney added.&lt;/p&gt;
&lt;p&gt;The entire report appears online in the &lt;em&gt;Journal of Clinical Oncology&lt;/em&gt;, but here is&lt;em&gt; a&lt;/em&gt; summary of developments related to some of the most common cancers.&lt;/p&gt;
&lt;p&gt;In an attempt to provide context and a diversity of viewpoints, &lt;em&gt;MedPage Today&lt;/em&gt;, in collaboration with ABC News, solicited comments from cancer specialists who were not involved in developing the ASCO publication. As appropriate, their views are included with the review of cancer research highlights.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Breast Cancer&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Results of a large, randomized clinical trial settled a longstanding debate about the superiority of a standard three-drug chemotherapy regimen versus monotherapy with capecitabine (Xeloda) for breast cancer in women 65 and older. Women randomized to the single agent had a twofold increase in the risk of relapse and death compared with women who received cyclophosphamide, methotrexate/fluorouracil, and doxorubicin. Three-year relapse-free survival was 68% with monotherapy and 85% with the combination. Overall survival was 86% with monotherapy versus 91% with the combination.&lt;/p&gt;
&lt;p&gt;Stefan Gluck, MD, of the University of Miami, had a different take on the study results. Acknowledging the better survival in the capecitabine arm, Gluck took issue with the trial&apos;s clinical significance. &quot;This is not major research. It did not change practice, did not change outcome, did not change toxicity, and did not change cost.&quot;&lt;/p&gt;
&lt;p&gt;On the other hand, Hyman Muss, MD, of the University of North Carolina in Chapel Hill, cited the trial results as an example of clinical research that has influenced his clinical practice in the past year.&lt;/p&gt;
&lt;p&gt;Two studies provided evidence that the investigational class of agents known as poly(ADP-ribose) polymerase (PARP) inhibitors has efficacy in so-called triple-negative breast cancer. The agents block cancer cells&apos; ability to repair DNA damage, including damage inflicted by chemotherapy.&lt;/p&gt;
&lt;p&gt;Seconding the ASCO specialists&apos; view, Gluck said the investigation of PARP inhibitors is a major accomplishment in the field of breast cancer.&lt;/p&gt;
&lt;p&gt;Michael J. Fisch, MD, of the University of Texas M.D. Anderson Cancer Center in Houston, agreed, calling PARP inhibitors &quot;a new category of treatment for a very difficult-to-treat subset&quot; of breast cancer patients.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Gastrointestinal Cancers&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;A large Phase III clinical trial of patients with HER2-positive gastric cancer had a significant reduction in the risk of death when treated with trastuzumab (Herceptin) plus standard chemotherapy compared with chemotherapy alone. Treatment with trastuzumab did not increase the risk of symptomatic congestive heart failure.&lt;/p&gt;
&lt;p&gt;British investigators reported data from a trial that established the first standard of care for biliary tract cancer. The combination of gemcitabine (Gemzar) and cisplatin significantly improved progression-free survival and overall survival compared with gemcitabine alone.&lt;/p&gt;
&lt;p&gt;Adding the targeted agent bevacizumab (Avastin) to standard chemotherapy did not reduce the risk of recurrence in early-stage colon cancer. The three-year disease-free survival was 77.4% with the investigational therapy and 75.5% with standard chemotherapy.&lt;/p&gt;
&lt;p&gt;M.D. Anderson&apos;s Fisch said oncologists had mixed reactions to the bevacizumab findings.&lt;/p&gt;
&lt;p&gt;&quot;On one hand, oncologists always want to see positive findings about new therapies, but some oncologists also noted that the overall healthcare expense associated with a positive finding on this particular study may have created some real dilemmas,&quot; he said.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Genitourinary Cancers&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Men with early-stage prostate cancer had about a 29% reduction in the risk of metastasis and 28% improvement in survival when they received adjuvant radiation therapy following radical prostatectomy. ASCO cancer specialists called the trial a &quot;practice-changing study.&quot;&lt;/p&gt;
&lt;p&gt;Two different drugs received FDA approval for treatment of renal-cell carcinoma. Everolimus (Afinitor), an inhibitor of mammalian target of rapamycin (mTOR) demonstrated activity in patients whose cancer had not responded to prior targeted therapy.&lt;/p&gt;
&lt;p&gt;Bevacizumab was approved for use in combination with interferon to treat metastatic renal cell carcinoma. Two different trials showed almost a doubling of progression-free survival with the bevacizumab combination compared with interferon alone, although overall survival improved only modestly.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Gynecologic Cancers&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Quarterly measurement of CA125 following treatment for ovarian cancer did not reduce the risk of recurrence. The findings from a European study showed that patients did not benefit from early treatment for relapse or recurrence based on CA125 results.&lt;/p&gt;
&lt;p&gt;Data from a large multicenter clinical trial demonstrated the efficacy of the human papillomavirus vaccine in older women. The vaccine protected women ages 24 to 45 from HPV infection and both benign and malignant disease of the cervix and genitalia in more than 90% of cases. ASCO specialists said the results show that older women who have not been infected by HPV may derive the same benefits observed in girls and younger women.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Head and Neck Cancers&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Adding the targeted agent cetuximab (Erbitux) to chemotherapy significantly improved progression-free survival and overall survival in patients with untreated recurrent or metastatic head and neck cancer. Noting failure of several previous trials to demonstrate a survival advantage with chemotherapy, ASCO cancer specialists said the findings should change clinical practice.&lt;/p&gt;
&lt;p&gt;Another targeted agent, gefitinib (Iressa), did not improve survival compared with methotrexate in patients with recurrent squamous-cell carcinoma of the head and neck.&lt;/p&gt;
&lt;p&gt;The practice of &quot;re-irradiation&quot; following chemoradiation therapy reduced the risk of local recurrence but did not improve survival in patients with adverse-feature head and neck cancer. Additional radiation reduced the risk of recurrence by 50%, but patients did not live any longer than those who received conventional chemoradiation followed by active surveillance. Moreover, re-irradiation led to a fourfold increase in the incidence of grade 3-4 toxicity.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Lung Cancer&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Maintenance therapy with pemetrexed (Alimta) significantly improved survival in patients with stage IIIB or IV nonsquamous, non-small cell lung cancer (NSCLC). The trial was the first to demonstrate a survival benefit with maintenance chemotherapy, which should now be considered the standard of care for patients with advanced NSCLC, ASCO cancer specialists concluded.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;EGFR&lt;/em&gt; mutations predicted response to treatment with gefitinib (Iressa) in Asian patients who were nonsmokers or light smokers. Patients with the mutations had a significant slowing of progression when treated with the targeted agent.&lt;/p&gt;
&lt;p&gt;M.D. Anderson&apos;s Fisch cited the mutation study as an example of advances that will &quot;likely guide the best choice of treatment.&quot;&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Melanoma&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;A vaccine that boosts the immune system&apos;s response to cancer doubled the response rate of melanoma when added to interleukin-2 (IL-2). Response rates were 9.7% with IL-2 alone and 22.1% with IL-2 and the vaccine.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Central Nervous System Cancers&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;FDA approval of bevacizumab provided the first new drug for glioblastoma in a decade. Two different trials demonstrated improved progression-free survival and overall survival in patients with advanced glioblastoma treated with bevacizumab.&lt;/p&gt;
&lt;p&gt;A monoclonal antibody that stimulates the immune system reduced the risk of recurrence and improved survival in patients with high-risk neuroblastoma. Known as ch14.18, the immunotherapy was associated with a two-year overall survival of 86% compared with 75% with standard therapy and relapse-free survival of 66% compared with 46%.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Hematologic Malignancies&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;A patient-specific therapeutic vaccine improved disease-free survival in patients with previously untreated follicular lymphoma. Patients randomized to the vaccine had a disease-free survival of 44.2 months compared with 30.6 months for patients who received a control vaccine.&lt;/p&gt;
&lt;p&gt;A targeted agent that homes in on an enzyme involved in inflammation and immune response demonstrated activity against several types of blood cancers in a Phase I clinical trial. Fostamatinib, which inhibits the enzyme Syk kinase, achieved measurable responses in 5% of patients with chronic lymphocytic leukemia, 21% of patients with diffuse large-cell lymphoma, 11% of patients with mantle-cell lymphoma, and 10% of patients with follicular lymphoma.&lt;/p&gt;
&lt;p&gt;&lt;em&gt;&lt;strong&gt;Cancer Prevention and Screening&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;Two large randomized clinical trials showed that routine screening for prostate cancer with PSA tests had little or no effect on prostate cancer mortality. ASCO cancer specialists said the message from the trials is that routine PSA testing detects a large number of clinically insignificant cancers and can lead to unnecessary treatment.&lt;/p&gt;
&lt;p&gt;The University of North Carolina&apos;s Muss said the PSA studies and the trial that evaluated CA125 as a guide to therapy both should have a practice-changing impact on oncology.&lt;/p&gt;
&lt;p&gt;The ASCO report also reviews the organization&apos;s major recommendations for the past year, emphasizing ASCO&apos;s support for increased funding for cancer research and removal of regulatory barriers to research, implementation of quality-of-care measures for cancer care, and elimination of barriers to access to high-quality cancer care.&lt;/p&gt;
&lt;p&gt;Focusing on policy issues, Roy Jones, MD, of M.D. Anderson, cited a need for insurance coverage that addresses the impact of new technology on the cost of healthcare. He suggested a two-tiered system of coverage comprising a basic insurance plan for &quot;proven cost-effective care&quot; and supplemental policies that &quot;willing purchasers would pay for the privilege of unproven high-tech.&quot;&lt;/p&gt;
&lt;p&gt;&quot;Since the current healthcare reform proposals fail to address the major cost driver, they are all unlikely to reduce costs,&quot; said Jones. &quot;On that pessimistic note, we might be able to consider this or similar plans the &apos;go round.&apos;&quot;&lt;/p&gt;
&lt;p&gt;&lt;em&gt;This article was developed in collaboration with ABC News. &lt;/em&gt;&lt;img src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; mce_src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; alt=&quot;&quot;&gt;&lt;/p&gt;
    </recommendedItem>
    <recommendedItem id="20090101_10_927"
                     title="High Birth Weight Increases Risk of Certain Cancers"
                     score="-0.007"
                     href="